Aetna Approved

I called Aetna on 3-4-05, they informed me that my appeal had been approved I had to ask the girl twice are you serious I was so excited I told everyone, I couln't contain myself. The Approval letter was waiting on me when I got home. I want to thank everyone who has posted on this form in all of our struggles and triumph we help each other succeed. I will do my best to give back as much as everyone has given me. I'm calling the surgeon on 3-7-05 to get a date. I will keep everyone updated.

I have Aetna also and I'm just beginning this process. Why do I keep hearing that WLS will no longer be covered as of Jan 1, 2005? Do you have any idea? Congrats on approval! I hope I can get the same good news!

I was also hearing that WLS was no longer going to be covered as of Jan 1, 2005. I don't know if it is policy specific or state specific. I called my benefits manager at my job and Aetna both to make sure that the WLS would be covered. I also checked Aetna Clinical Policies and Procedures to see what thier criteria was for WLS, then I followed it to the letter. They still denied me on my initial claim, this has become a nationwide trend, but I didn't give up. I wrote a Appeal letter and gathered the additional information Aetna wanted, two weeks later they approved the coverage for WLS. Good luck in your journey, DO NOT GIVE UP, no matter how hard it gets, if you want it, you will find a way.

Thank you. I'm going to keep trying, but I found my company's exclusion clause this morning. I didn't see it before, but there it is! I'm wondering if I can get around it because it doesn't specify MORBID obesity, just obesity. Congrats again to you!

FANTASTIC!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I'm so happy for you Robert. Like tell everyone. Don't give. Never let anyone takes your dreams away from you. Best of luck Donna 338/256 -82

Congratulations!

My wife was also denied by Aetna. I think they are simply changing the policy to meet the ever demand for this surgery. What I mean by need is their need not to pay for this type of surgery and to make it as difficult as possible to approve.

Hi, Just curious if you called the main number, or the precertification dept. My lawyer told me last week that they said they had mailed me a letter last Thursday ( i don't know if it's approval or denial) but I haven't received it yet. When I call precert, they tell me that the main number is where I should call, and when I call the main number, they say they have no record of any appeal - which I know is not true My lawyer has proof of service. Of course I am extremely anxious to find out. Connie